Comparative Study Of Using Myofascial Vastus Lateralis Flaps Or Anterolateral Thigh Flaps To Reconstruct Oral Defects After Cancer Ablation

Objective:The free anterolateral thigh flaps(ALTF)has become the most widely used free flap in body soft tissue defects reconstruction because it is located in the anterolateral region of the thigh and can carry more skin,muscle and other tissues.However,using ALTF to restore the oral defects obviously exists drawbacks,such as delayed healing,unsatisfactory coherence of tissue texture and epidermal color,redundant subcutaneous fat and skin,donor morbidity and so on.While using myofascial vastus lateralis flaps(MVLF)can improve these side effects in clinical cases.The aim of this study was to compare the application of MVLF and ALTF in reconstituting oral defects after oncological ablation.Methods:A retrospective review of 60 cases'oral defects reconstruction performed at the affiliated hospital of Qingdao University between 2017 and 2020 was conducted.30patients received the MVLF and 30 patients received the ALTF was involved in our study.We compared their basic surgical information and the postoperative functional data of the two groups using IBM SPSS 26.0 Statistics software.The basic information included sex,age,size and pathology of the tumor,stage of TNM and healthy condition;and surgical data consisted the size and preparation time of the flaps,the cost of operation,the postoperative length of stay and the survival condition of flaps.Postoperative diet,the degree of mouth opening,the sense of thermesthesia and the recurrence and metastasis of cancer was involved in the postoperative functional information.The measurement data was shown as'X±s'and the differences between two groups were compared using a two tailed Student's t tests or?~2test which is more suitable for qualitative data.The mann-whitney U non-parametric test of two independent samples was used for those who did not meet the?~2test conditions.When P-value of<0.05,the difference is statistically significant.Results:There was no significant difference in basic information between MVLF group and ALTF group(P>0.05).Compared with ALTF,the preparation time and postoperative length of stay in MVLF group was shorter(P<0.05).After two-month followed up,the MVLF was gradually identical to adjacent or residual mucosa,with smooth and wet surface.The recovery rates of thermesthesia for MVLF were 70%,and for ALTF were43.3%in two-year follow-up,respectively(P<0.05).Conclusions:Both MVLF and ALTF are ideal flaps for reconstruction of oral defects after cancer ablation.Because they conceive many aspects of advantages,like providing large area,constant vascular pedicle,concealed donor area and little influence on function of postoperative donor area.Compared with the ALTF,the MVLF has particular advantage in repairing oral cancer defect,such as no need to dissect the skin perforation of musculocutaneous artery,saving the operation time,reducing the skin defect in the donor area,enhancing the survival rate of flap.After repairing,the oral mucosa epithelium was smooth and ruddy,the temperature sensitivity and the degree of comfort increased.The MVLF could provide unique features for the reconstruction of oral and defects in a reliable and versatile approach.